Electrical activity of the masseter during swallowing after total laryngectomy

Abstract

Tot al laryngectomy is a surgical procedure that can change swallowing biomechanics, including muscle activity of the masseter; this muscle stabilizes the mandible. Aim: To characterize the electrical activity of the masseter muscle during swallowing after total laryngectomy. Series study. Material and Methods: An electromyographic evaluation of swallowing was carried out; three different volumes of water (14.5ml, 20ml and 100ml) were swallowed, and there was a rest condition. The electromyographic signal was normalized by Maximum Resisted Voluntary Activity-considered as 100% of electrical activity of muscles. All other values were calculated as a percentage of this parameter. Results: There is moderate electrical activity of the masseter during swallowing with higher averages on the left. There was no difference between swallowing 14.5ml or 20ml. Natural swallowing of 100ml had the lowest average. Electromyographic signals were recorded at rest on both sides, indicating the existence of electric activity in this situation. Conclusion: Patients submitted to total laryngectomy present electrical activity of the masseter muscles during swallowing and at rest. This activity is influenced by the volume of swallowed liquid, and showed significant differences among the tasks. Clinical Trials: NCT01095289

Diagnosis and treatment of oropharyngeal dysphagia after total laryngectomy with or without pharyngoesophageal reconstruction: Systematic review

“…[36][37][38][39][40][41][42][43][44] All case series were classified as level C evidence. [45][46][47][48][49][50][51][52][53][54][55][56] None of the 44 articles met all critical appraisal criteria (Table 3). Seventeen articles fulfilled all criteria for external validity, 13,17,22,[26][27][28]30,32,35,36,[38][39][40]44,46,49,50 and six studies did not fulfill any of these criteria.…”

“…[45][46][47][48][49][50][51][52][53][54][55][56] None of the 44 articles met all critical appraisal criteria (Table 3). Seventeen articles fulfilled all criteria for external validity, 13,17,22,[26][27][28]30,32,35,36,[38][39][40]44,46,49,50 and six studies did not fulfill any of these criteria. 14,19,33,34,42,45 Two of the included articles fulfilled all criteria for internal validity, 18,48 representing a low risk of bias.…”

“…Thirty studies applied statistical analytic methods. 13,[15][16][17][18][19][20][21][22][23][25][26][27][28][29][30][31][32][33][35][36][37][38][40][41][42][43][44]46,47 6 | DIAGNOSIS OF OD AFTER TLE…”

“…This subsection presents a summary of the functional and anatomical signs of OD per study. A diversity of swallowing assessment methods were applied after TLE with or without pharyngeal reconstruction: VFSS 15 46 ; functional lumen imaging (Endoflip) 47 ; and the Dysphagia Outcome and Severity Scale (DOSS) assessed with barium swallow. 30 The time interval from surgery to swallowing assessment ranged from five days 24 to 23 years.…”

“…These omissions introduce the potential for selection and reporting bias 12. In 14 studies, extrapolation of the results to all TLE patients can be compromised due to the poor internal validity or small sample sizes (≤20 study participants) 18,19,31,[46][47][48][49][50][51][52][53][54][55][56]. The overall internal validity of 44 studies was of moderate quality.…”